April 18, 2025
Sports cardiology is an advancing subspecialty of cardiology that caters to more than elite athletes. The field focuses on the care of active individuals and athletes, both youths and adults, with known or previously undiagnosed cardiovascular conditions.
Exercise demands can cause many heart and vascular changes and it's crucial to see experts who can distinguish physiologic changes from pathology. Sports cardiologists are specialists who understand screening and risk stratification for people with and without known cardiovascular diseases. They offer exercise recommendations for individuals following comprehensive assessments that may include:
- Use of echocardiography, cardiac MRI and cardiac CT.
- Cardiopulmonary exercise testing (CPET) specific to athletic patients.
- Genetic counseling when appropriate.
"Sports cardiology largely evolved out of the shared understanding that high levels of exercise training can have significant impact and implications on the heart. Using 'standard' clinical evaluations for athletes and highly active individuals fails to capture the complexity and nuances of the heart of an athlete," says Kathryn F. Larson, M.D., a sports cardiologist at Mayo Clinic in Rochester, Minnesota.
Sports cardiology misconceptions
There are misconceptions about the niche subspecialty. "People think sports cardiology is only for professional athletes or young adults and that's not true. Exercise is a priority for people of all ages. Since the risk of cardiovascular disease increases with age, navigating athletic activity in older adults is a common scenario for sports cardiologists. We're increasingly faced with treating disease in individuals who want to remain active running marathons or triathlons into their later adult years," says Dr. Larson.
Mayo Clinic's Sports Cardiology Clinic also cares for patients who must maintain a high level of physical fitness for work and are exposed to high-risk on-the-job cardiac situations, such as firefighters.
Common concerns with athletes include:
- Arrhythmias — Atrial fibrillation is frequent and can be heavily influenced by exercise.
- Valve disease.
- Coronary artery disease.
- Sport-specific cardiac problems.
When is play high risk?
Seeking care from sports cardiology specialists can help people stay active, even with cardiovascular disease. "Some cardiac conditions, though rare and not the only cause, can contribute to sudden death with exercise, particularly if they are not properly identified. A sports cardiologist has expertise in exercise physiology and a strong understanding of the situational, environmental and sport-specific concerns that can arise for their patients," says Dr. Larson.
"In youth and young adults, we've gotten much better at understanding the factors which contribute to risk of sudden death with exercise. Many young athletes with heart conditions previously considered high risk are now returning to play thanks to better risk stratification, treatment and collaboration between cardiologists, sports medicine physicians, and athletic teams and organizations," says Dr. Larson.
Team expertise
At Mayo Clinic's Sports Cardiology Clinic, experts use a team-based, multidisciplinary approach to patient care. The wide range of experts includes electrophysiologists, exercise physiologists, interventional cardiologists, cardiovascular surgeons, nutritionists, physical medicine and rehabilitation specialists, sports psychologists, and geneticists. Among the sports cardiologists, there are specialists with expertise in the pediatric heart, congenital heart disease, inherited diseases and heart failure.
People who may benefit from a sports cardiology consultation include:
- Young athlete with an abnormal cardiac finding in a preparticipation physical exam.
- Adult patients with new symptoms during training such as chest pain, palpitations or a decrease in exercise tolerance.
- Athletes with a family history of heart disease that needs to be assessed prior to playing sports.
"The experts at Mayo Clinic's Sports Cardiology Clinic understand the physical demands of competitive sports, the psychology of athletes and the complexity of exercise physiology in cardiovascular disease," says Dr. Larson. "Our multidisciplinary sports cardiology team is uniquely positioned to help ensure patients receive care that's integrated, individualized and cutting edge."
Specialists at the Sports Cardiology Clinic in Arizona, Florida and Minnesota, are ready to work with you.
For more information
Refer a patient to Mayo Clinic.